Genesis 1 posterior cruciate-retaining total knee arthroplasty with asymmetric tibial tray: An 18-to-26-year long-term clinical outcome study.

BACKGROUND: To present the long-term clinical and radiological outcomes of the Genesis I posterior cruciate-retaining total knee arthroplasty (TKA) (Smith & Nephew Orthopaedics, Memphis, TN, USA) (one of the first designed with an asymmetric tibial tray). METHODS: Prospectively collected data from 117 cemented TKAs performed on 95 patients were evaluated using this design, with a mean follow-up of 21.5 years (range, 18-26). Failures, complication rates, and clinical (both subjective and objective) and radiological outcomes were assessed for all patients. RESULTS: Seven failures occurred (wear and structural failure of the polyethylene insert) and six revision surgeries were performed at a mean of 10 years (range, three to 14) from the index operation. No revision of either the femoral or tibial components for aseptic loosening was performed. Survivorship analysis showed a cumulative success rate of 93.53% (95% CI, 92.75-94.32%) at 20 and 25 years, with revision for any reason as an end point. All patients showed a statistically significant improvement (P = 0.001) in the Knee Society and Oxford knee rating scores. CONCLUSIONS: This study demonstrated satisfactory long-term clinical outcomes for this TKA design, with revisions being related to polyethylene wear structural failure.

Clinical and Radiological Results of Total Knee Arthroplasty with a System of Asymmetric Tibial Tray

PURPOSE: PURPOSE of this study was to evaluate the clinical and radiological results and complications of total knee arthroplasty(TKA) using the systems including an asymmetric tibial tray and a deep trochlear-grooved femoral component. MATERIALS AND METHODS: Ninety-five total knee replacement arthroplasties(68 patients) with the implant system, which has the asymmetric tibial tray and a deep trochlear grooved femoral component were analyzed clinically and radiologically. Retrograde analysis with the Knee Society clinical rating system, roentgenographic evaluation and scoring system and the Hospital for Special Surgery(HSS) score were done. The patients were average 66 years old and the follow-up period was 23month(range, 12 month to 49 month). RESULTS: Knee score was improved from 43 points to 90 points. Function score was improved from 47 points to 85 points. HSS score was improved 57 points to 89 points. Tibio-femoral angle was improved from varus 4o to valgus 5o. In last clinic visit, there was no case which had progressive radiolucent line or above 4 points in radiolucent score except one septic loosening case. There was no case of patellofemoral complications, including patellofemoral instability, patellar fracture, patellar component failure, patellar component loosening, and patellar clunk syndrome. CONCLUSTION: The TKA in this series showed excellent clinical and radiological results and low inci- dence of patellar complication.